Dawn Smoker
Newville,PA
Summary
Experienced Registered Nurse with over 20 years in clinical leadership across long-term care, skilled nursing, rehabilitation, and acute care. Expertise in MDS 3.0, RAI process, PDPM reimbursement, and Medicare regulations. Proven track record in enhancing reimbursement accuracy, ensuring regulatory compliance, and mentoring interdisciplinary teams to achieve positive resident outcomes.
Overview
1
1
Certification
22
22
years of professional experience
Work History
Clinical Nurse Consultant
AdvantageCare Rehabilitation
Pittsburgh, PA
03.2022 - Current
- Advise leadership teams on CMS Five-Star Quality Rating initiatives.
- Guide facilities in improving PDPM reimbursement accuracy and Case Mix Index performance.
- Supported compliance with Quality Reporting Program (QRP) and Value-Based Purchasing (VBP) initiatives, ensuring adherence to regulatory standards.
- Serve as an expert resource for MDS 3.0, the RAI process, and ICD-10 coding.
- Conduct clinical documentation and reimbursement audits.
- Interpret and communicate new CMS regulations and reimbursement changes.
- Assist facilities in developing restorative nursing programs and improving resident outcomes.
- Facilitated RNAC support group meetings to identify and address member needs, fostering a supportive environment.
- Developed resource documents, newsletters, and articles to enhance communication and knowledge sharing.
Clinical Reimbursement Manager
Claremont Nursing & Rehabilitation Center
Carlisle, PA
08.2018 - Current
- Direct all clinical reimbursement operations for the facility.
- Monitored and optimized case mix index (CMI) to enhance reimbursement accuracy.
- Audit MDS accuracy to maximize PDPM reimbursement.
- Ensure MDS assessments comply with CMS and RAI guidelines.
- Perform concurrent clinical reviews with insurance providers.
- Collaborate with admissions to evaluate referrals and reimbursement opportunities.
- Supervise a team of RN and LPN Assessment Coordinators.
- Reviewed CASPER reports and participated in quality assurance and performance improvement (QAPI) initiatives.
- Lead weekly Medicare utilization review meetings.
- Monitor Quality Reporting Program measures to maintain Annual Payment Update eligibility.
- Analyzed hospital readmissions and emergency department utilization, contributing to improved value-based purchasing outcomes.
RN Restorative & Wound Nurse Coordinator
Cross Keys Village – The Brethren Home Community
New Oxford, PA
11.2016 - 06.2018
- Coordinated restorative nursing and wound care programs to enhance patient recovery.
- Supervised restorative nursing staff and wound care nurse.
- Evaluated and revised restorative care plans based on resident assessments.
- Collaborated with therapy services to maximize functional outcomes.
- Analyzed quality measures and restorative programming for continuous improvement.
- Conducted employee evaluations and performance coaching to support staff development.
- Participated in interdisciplinary care planning and quality improvement initiatives.
Assistant RN Assessment Coordinator / Nursing Administration
Cross Keys Village – The Brethren Home Community
New Oxford, PA
04.2015 - 11.2016
- Conducted comprehensive assessments to determine patient care needs and develop individualized care plans.
- Completed resident interviews and MDS assessments.
- Developed individualized care plans.
- Coordinated transitions from hospital to skilled nursing to enhance patient continuity of care and minimize readmission risks.
- Managed Medicare PPS schedules and census changes to ensure optimal resource allocation and compliance.
- Participated in daily interdisciplinary clinical reviews.
- Assisted with regulatory audits and quality assurance initiatives to maintain high standards of care and compliance.
- Collaborated with interdisciplinary teams to ensure cohesive delivery of patient services and quality care.
RN Assessment Coordinator (RNAC)
Cumberland Crossings
Carlisle, PA
12.2013 - 04.2015
- Conduct comprehensive assessments to determine patient care needs and develop individualized care plans.
- Scheduled PPS and OBRA assessments to ensure compliance and timely care delivery.
- Collaborate with interdisciplinary teams to ensure coordinated and effective patient care delivery.
- Facilitated RAI process in collaboration with the interdisciplinary team to enhance patient care.
- Maintained Medicare reimbursement documentation to support accurate claims and financial integrity.
- Coordinated utilization review meetings to align clinical practices with reimbursement standards.
- Worked closely with therapy and nursing leadership to optimize reimbursement.
- Managed Medicare Advantage authorizations and insurance reviews.
- Monitor patient progress and adjust care plans based on clinical evaluations and feedback.
Registered Nurse Assessment Coordinator
Green Ridge Village
Newville, PA
03.2013 - 12.2013
- Managed MDS 3.0 assessments to enhance accuracy and compliance.
- Coordinated interdisciplinary assessments to ensure comprehensive resident care.
- Developed resident-centered care plans.
- Educated staff on documentation standards to improve regulatory adherence.
- Assisted with survey readiness and regulatory compliance.
Progressive Care Registered Nurse
Chambersburg Hospital
Chambersburg, PA
05.2012 - 12.2012
- Delivered care to critically ill cardiac patients.
- Monitored telemetry and cardiac rhythms to detect arrhythmias and ensure timely intervention.
- Managed post-cardiac catheterization patients.
- Administered IV medications and titrated critical care drips.
- Educated patients and families on cardiac disease management to enhance understanding and adherence to treatment plans.
- Collaborated with multidisciplinary care teams to coordinate comprehensive care and improve patient outcomes.
Registered Nurse House Supervisor
Roxbury Treatment Center
Shippensburg, PA
02.2010 - 05.2012
- Supervised nursing staff across multiple behavioral health units to maintain high standards of patient care.
- Responded to medical and behavioral emergencies.
- Investigated incidents and resolved patient concerns, enhancing patient satisfaction and safety.
- Ensured regulatory compliance and quality documentation to uphold safety standards and improve care outcomes.
- Conducted infection control and safety rounds.
Registered Nurse Supervisor
Green Ridge Village
Newville, PA
12.2008 - 04.2010
- Supervised nursing staff on skilled nursing units to ensure optimal patient care and adherence to clinical standards.
- Coordinated patient care and physician communication to streamline treatment plans and enhance patient outcomes.
- Managed medication administration and clinical documentation.
- Engaged in quality improvement initiatives to enhance patient care processes, resulting in improved care protocols.
Progressive Care Registered Nurse
Ephrata Community Hospital
Ephrata, PA
10.2007 - 12.2008
- Managed telemetry, IV therapy, blood products, and central lines.
- Delivered intermediate cardiac care to stabilize patients and ensure optimal recovery.
- Coordinated multidisciplinary care and facilitated patient education to enhance understanding of treatment plans.
- Supported healthcare team during bedside procedures by preparing necessary equipment and ensuring patient comfort.
Licensed Practical Nurse
HealthSouth Reading Rehabilitation Hospital
Reading, PA
09.2004 - 04.2006
- Delivered comprehensive nursing care to neuro-trauma rehabilitation patients, ensuring optimal recovery and quality of life.
- Conducted thorough neurological assessments and provided wound care, contributing to effective patient management.
- Administered tracheostomy care in a clinical setting. and medication administration.
- Partnered with physicians and rehabilitation teams to develop and implement individualized care plans.
Education
Diploma - Nursing (RN)
Brandywine Hospital School of Nursing
Coatesville, PANursing Studies
Harrisburg Area Community College
Lancaster, PAPractical Nursing Diploma - LPN
Lancaster County Career & Technology Center
Willow Street, PASkills
- MDS 30 & RAI Process
- PDPM Reimbursement
- Clinical Reimbursement Management
- Case Mix Index (CMI)
- CMS Regulations & Compliance
- Medicare & Managed Care
- Quality Reporting Program (QRP)
- Value-Based Purchasing (VBP)
- Quality assurance
- Clinical Auditing
- Utilization Review
- Quality improvement
- Restorative Nursing
- Wound Care
- Clinical assessment
- Care Planning
- Clinical decision making
- Team leadership
- Interdisciplinary teamwork
- Healthcare Collaboration
- Healthcare administration
- Ethical practice
- ICD-10 Coding
- Team leadership
- Clinical decision making
Affiliations
American Association of Post-Acute Care Nursing (AAPACN)
Pennsylvania Association of Nurse Assessment Coordinators (PANAC)
Certification
- Registered Nurse (RN) – Pennsylvania
- Licensed Practical Nurse (LPN)
- RAC-CTA (Resident Assessment Coordinator – Advanced)
- RAC-CT (Resident Assessment Coordinator – Certified)
- ICD-10-CM Course Certificate
- Former Wound Care Certification (WCC)
Timeline
Clinical Nurse Consultant
AdvantageCare Rehabilitation
03.2022 - Current
Clinical Reimbursement Manager
Claremont Nursing & Rehabilitation Center
08.2018 - Current
RN Restorative & Wound Nurse Coordinator
Cross Keys Village – The Brethren Home Community
11.2016 - 06.2018
Assistant RN Assessment Coordinator / Nursing Administration
Cross Keys Village – The Brethren Home Community
04.2015 - 11.2016
RN Assessment Coordinator (RNAC)
Cumberland Crossings
12.2013 - 04.2015
Registered Nurse Assessment Coordinator
Green Ridge Village
03.2013 - 12.2013
Progressive Care Registered Nurse
Chambersburg Hospital
05.2012 - 12.2012
Registered Nurse House Supervisor
Roxbury Treatment Center
02.2010 - 05.2012
Registered Nurse Supervisor
Green Ridge Village
12.2008 - 04.2010
Progressive Care Registered Nurse
Ephrata Community Hospital
10.2007 - 12.2008
Licensed Practical Nurse
HealthSouth Reading Rehabilitation Hospital
09.2004 - 04.2006
Practical Nursing Diploma - LPN
Lancaster County Career & Technology Center
Diploma - Nursing (RN)
Brandywine Hospital School of Nursing
Nursing Studies
Harrisburg Area Community College
Professional Strengths
- Clinical Reimbursement
- Medicare Compliance
- PDPM
- MDS 3.0
- RAI Process
- Case Mix Index
- ICD-10 Coding
- Clinical Documentation Improvement
- Five-Star Quality Rating
- Quality Reporting Program
- Utilization Review
- Clinical Auditing
- Restorative Nursing
- Leadership
- Regulatory Survey Readiness